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• W2034349094 abstract "No AccessJournal of UrologyAdult urology1 Dec 2007Missed Diagnoses by Urologists Resulting in Malpractice Payment William J. Badger, Michael E. Moran, Christa Abraham, Bharat Yarlagadda, and Michael Perrotti William J. BadgerWilliam J. Badger More articles by this author , Michael E. MoranMichael E. Moran More articles by this author , Christa AbrahamChrista Abraham More articles by this author , Bharat YarlagaddaBharat Yarlagadda More articles by this author , and Michael PerrottiMichael Perrotti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.08.040AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Missed diagnoses are a patient safety concern and they can result in malpractice allegation. The specialist physician may be liable for missed or delayed diagnoses even if an abnormality in the physician area of expertise is ruled out. We approached this largely unstudied area of medical malpractice in an effort to increase physician awareness and identify opportunities for prevention. Materials and Methods: Working with the Medical Liability Mutual Insurance Company of New York State, we evaluated malpractice claims in urology that were closed with indemnity payment between 1985 and 2004. We identified all such claims resulting from alleged missed or delayed diagnoses by urologists. Claims were divided into 2 main categories based on whether the missed diagnosis was primarily urological, ie testis torsion, or not urological, ie appendicitis. Results: A total of 75 missed diagnosis claims were identified, representing 15% of claims overall. The total indemnity payment for missed diagnosis claims was $32,591,013, which represented 27% of all indemnity payments for the study period. They were divided into 58 missed urological diagnoses and 17 missed nonurological diagnoses. Cancer represented 71% of missed urological diagnoses and 41% of missed nonurological diagnoses. Urological cancer missed diagnosis claims were associated with the highest average indemnity payment of $526,460. The average indemnity payment for missed diagnosis claims was 92% greater than the average indemnity payment for all other claims ($434,546 vs $226,133). An increase in the frequency of missed diagnosis claims closed with indemnity payment and in the amount of payment for missed diagnosis claims were observed during the 20-year study period. Conclusions: Indemnity payments resulting from missed diagnosis claims represent a disproportionately high percent of total indemnity payments (27%) due to a high average payment for such claims. Liability for the urologist resulted from missed diagnoses not only of urological conditions, but also of nonurological conditions. References 1 : The growth of physician medical malpractice payments: evidence from the national practitioner data bank. Health Aff2005; : W5240. (Millwood). Google Scholar 2 : Learning from malpractice claims about negligent, adverse events in primary care in the United States. Qual Saf Health Care2004; 13: 121. Google Scholar 3 : Urologists hit by malpractice crisis. Renal Urol News2005; : 42. July/August. Google Scholar 4 : Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA2005; 293: 2609. Google Scholar 5 : America’s medical liability crisis: the AMA’s view. Renal Urol News2005; . September 26. Google Scholar 6 : Medical malpractice in urology, 1985 to 2004: 469 consecutive cases closed with indemnity payment. J Urol2006; 176: 2154. Link, Google Scholar 7 : Malpractice risks for urologists. Urology1998; 51: 183. Google Scholar 8 : Medical liability—the crisis, the reality, and the data: the University of Michigan story. J Am Coll Surg2006; 203: 290. Google Scholar 9 : Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Ann Int Med2006; 145: 488. Google Scholar 10 : Claims, errors, and compensation payments in medical malpractice litigation. N Engl J Med2006; 354: 2024. Google Scholar Urology Service, St. Peter’s Cancer Care Center and Department of Surgery, Albany Medical College, Albany, New York© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byXu L, Ambinder D, Siddiqui M and Malik R (2020) A 30-Year Review of Cystectomy LitigationUrology Practice, VOL. 8, NO. 1, (18-22), Online publication date: 1-Jan-2021.Erickson B, Han Y, Meeks W, Gulig S, Fang R, Annam K and Nepple K (2016) Increasing Use of Advanced Practice Providers for Urological Office Procedural Care in the United StatesUrology Practice, VOL. 4, NO. 2, (169-175), Online publication date: 1-Mar-2017.Sunaryo P, Colaco M, Davis R and Sadeghi-Nejad H (2014) Malpractice Litigation in the Setting of Prostate Cancer DiagnosisUrology Practice, VOL. 2, NO. 1, (17-21), Online publication date: 1-Jan-2015.Duty B, Okhunov Z, Okeke Z and Smith A (2011) Medical Malpractice in Endourology: Analysis of Closed Cases From the State of New YorkJournal of Urology, VOL. 187, NO. 2, (528-532), Online publication date: 1-Feb-2012.Benson J and Coogan C (2010) Urological Malpractice: Analysis of Indemnity and Claim Data From 1985 to 2007Journal of Urology, VOL. 184, NO. 3, (1086-1090), Online publication date: 1-Sep-2010.Stimson C, Pichert J, Moore I, Dmochowski R, Cornett M, An A and Hickson G (2010) Medical Malpractice Claims Risk in Urology: An Empirical Analysis of Patient Complaint DataJournal of Urology, VOL. 183, NO. 5, (1971-1976), Online publication date: 1-May-2010. Volume 178Issue 6December 2007Page: 2537-2539 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsinsuranceliabilitymalpracticeurologyinsurance claim reviewdiagnostic errorsMetricsAuthor Information William J. Badger More articles by this author Michael E. Moran More articles by this author Christa Abraham More articles by this author Bharat Yarlagadda More articles by this author Michael Perrotti More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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